Our mission:
- A multi-disciplinary, collaborative alliance of University of Washington health sciences research groups focused on comparative effectiveness research, technology assessment, and health system evaluation
- Community of engaged peers, research teams and like-minded collaborators
- Builds upon existing and available resources and creates economies of scale for high-impact research
News & Events
News
- April 30
- Electronic Health Records Help Researchers Harness Data
- Issue 3, April 2012
EHC Inside Track
Agency for Healthcare Research and Quality
Emerging initiatives funded by the Agency for Healthcare Research and Quality (AHRQ)’s Effective Health Care Program are exploring how electronic health records (EHRs) and their connections to other databases can be used by scientists to conduct comparative effectiveness research. The projects will establish and enhance computerized clinical data systems to address limitations encountered in observational studies and in randomized controlled trials. For example, while well-designed trials may yield valid conclusions, their findings are based on studies of highly selected groups of patients. Therefore, their conclusions can rarely be generalized to real-world clinical practice.
Read More >> http://www.ahrq.gov/clinic/insidetrack/#art1
- April 28
- Dartmouth Atlas of Health Care has released Medicare spending data for 2009
- The data are available for two adjustment levels: age, sex and race only, and age, sex, race and price.
The data can be found on the website: http://www.dartmouthatlas.org/data/topic/topic.aspx?cat=21
- April 18
- The Patient-Centered Outcomes Research Institute (PCORI) National Priorities for Reseach and Initial Research Agenda
- April 18, 2012, Vol 307, No. 15, pp 1555-1657
The Journal of the American Medical Association
Selby, J. et al.
The Patient Protection and Affordable Care Act of 2010 created the Patient-Centered Outcomes Research Institute (PCORI) to fund and promote comparative clinical effectiveness research (CER) that will “assist patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence concerning the manner in which diseases, disorders, and other health conditions can effectively and appropriately be prevented, diagnosed, treated, monitored, and managed through research and evidence synthesis.” CER is not a new concept, but appreciation of its potential for providing patients and their clinicians with uniquely valuable information on what works, tailored to the clinical situation and to patient priorities, has increased rapidly in recent years.
Read More >> http://jama.ama-assn.org/content/307/15/1583.full
Upcoming Events
- May 21
- CHASE Works-in-Progress - 3pm to 5pm in room H670
- Speaker: Jeffrey R. Harris, MD, MPH, MBA; Professor, UW Department of Health Services; Director, Health Promotion Research Center
Christian D. Helfrich, MPH, PhD; Implementation Research Coordinator, VA Quality Enhancement Research Initiative on Ischemic Heart Diseases; Research Assistant Professor, UW Department of Health Services
Topic: The science of dissemination and implementation: What it is; why it’s important; and some examples of how it’s done
Time: 3pm - 5pm
Room: Health Sciences Bldg. H670 - May 18
- Harborview Injury Prevention Research Center, Works-In-Progress
- Speaker: Jeffrey G. Jarvik, MD, MPH - Professor of Radiology and Neurosurgery, University of Washington, Director, Comparative Effectiveness, Cost and Outcomes Research Center
Topic: Lumbar Image Reporting with Epidemiology
Time: 9:30-10:30am
Location: HIPRC Conference Room (Pat Steele Bldg. 401 Broadway, Suite 4075 - May 14
- CHASE Works-In-Progress - 3pm to 5pm in H371 (Health Sciences Building)
- Speaker: Sarah Ringold, MD, MS, K12 Scholar - Rheumatology, Seattle Children's Hospital
Topic: Integrating PRO's into our national registry of children with rheumatic diseases
Time: 3-4pm
Speaker: Josh Carlson, PhD, MPH, K12 Scholar - Assistant Professor, UW Department of Pharmacy
Topic: Aligning Genomic Testing with Patient and Physician Preferences in NSCLC (AGENT-P)
Time: 4-5pm
Adobe Connect instructions:
Go to http://confer.uw.edu/deptpharm .
Login as a guest. Type your name into the field and click Enter Room.
Click the Request Entry button.
To join the call, dial 1-800-379-6841 Participant Code: 394654
Research Spotlight
Research Spotlight: Lead PI Larry Kessler, ScD, ADVancing Innovative Comparative Effectiveness (ADVICE) Research in Cancer Diagnostics.
Other PIs: Diana Buist, PhD, MPH, Group Health Research Institute; Scott Ramsey, MD, PhD Fred Hutchinson Cancer Research Center; and Sean Sullivan, PhD, MS, University of Washington.
Stakeholders: Data Providers: Centers for Medicaid and Medicaid Services, Group Health Cooperative, Regence, Premera Blue Cross, Uniform Medical Plan, and the VA. Others: Cascade Cancer Center Evergreen, Puget Sound Health Alliance, Seattle Cancer Care Alliance, and the Washington State Health Care Authority.
Project Sponsor: National Cancer Institute
Objectives:
1. Develop an infrastructure in Western Washington for performing rapid-response community-based cancer imaging and in-vitro diagnostics comparative effectiveness research (CER)
2. Conduct two retrospective proof of principle CER studies on cancer diagnostics identified through an informed stakeholder process.
ADVICE is a multi-institutional and multi-disciplinary research project. The University of Washington, Fred Hutchinson Cancer Research Center, and Group Health Research Institute work with a group of community stakeholders that includes private payers: (Premera and Regence), a managed care organization (Group Health Cooperative), public entities (Centers for Medicare and Medicaid Services, Health Care Authority, and Veterans Affairs of Puget Sound Health Care System,), and cancer-specific clinical providers (Cascade Cancer Center and Seattle Cancer Care Alliance). Together the ADVICE network represents approximately 80% of insured patients in the Western Washington region. The research team consists of experts from a variety of disciplines including radiology, oncology, medical imaging, health economics, and healthy policy.
The grant proposal identified breast cancer as the subject for the first proof of principle study. Through a continuous stakeholder engagement process, the focus was narrowed to the use magnetic resonance imaging (MRIs) in breast cancer staging (Study #1) and its effect on breast cancer treatments and healthcare costs. The second proof of principle study (Study #2), positron emission tomography (PET) versus traditional imaging for lung cancer staging, was determined entirely through this stakeholder process.
Study #1 - MRIs and breast cancer staging
Data use agreements with payers (Regence, Premera Blue Cross, Uniform Medical Plan, Group Health, Medicaid, and Medicare) were developed and executed. Payers submitted claims and enrollment data to ADVICE's data coordinating center which linked payer data to the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) Cancer Registry. A list of patients with SEER-confirmed breast cancer was then sent back and cancer claims data were obtained for each of the linked patients. The data from the multiple payers were combined into a single dataset. Currently researchers are cleaning data, clarifying and refining variables and discussing and resolving coding issues. In addition, they are beginning to fill draft tables and conduct preliminary analyses. The first manuscript will address the variability in breast imaging in our local community. The second will examine variation in treatment paths among women who received advanced imaging, compared to those who did not. And, a third manuscript will compare costs of care in women who received advanced imaging compared to those who did not, among a subgroup of the study patient population.
Study #2 - PET vs. traditional imaging for lung cancer staging
Data use agreements with the same six payers were developed and executed. Claims and enrollment data from four of the six participating payers have been received. Once data have been received from all payers, they will be linked to SEER lung cancer cases, then they will be cleaned and draft tables prepared for analysis and manuscripts. An analysis of whether PET scans reduce futile invasive lung surgery in Veterans Administration patients with non-small cell lung cancer (NSCLC), the most common form of lung cancer, is currently underway.
ADVICE was able to pool data from a heterogeneous group of payers and develop methodologies for addressing specific challenges of medical diagnostics CER. In the near future the ADVICE research team will be able to determine the health and economic outcomes of these particular diagnostic imaging procedures. Obtaining the necessary IRB approvals and data use agreements was a large and challenging task, but the commitment of the stakeholder and advisory groups attests to the need and importance of this type of collaborative work.
In addition to multiple presentations on ADVICE, the following manuscripts have been accepted for publication:
• Cancer Imaging (a British journal) has published the following ADVICE paper for publication: The Emergence of Diagnostic Imaging Technologies in Breast Cancer: Discovery, Regulatory Approval, Reimbursement, and Adoption in Clinical Guidelines.
• The Journal of Comparative Effectiveness Research has accepted the ADVICE paper: Prioritizing Comparative Effectiveness Research Using a Regional Stakeholder Approach.